What question did this study set out to answer?

To evaluate how radiation dose, chemotherapy, and hormonal factors affect secondary breast cancer risk among female Hodgkin's disease survivors.

July 1, 2003JNCI Journal of the National Cancer Institute

Roles of Radiation Dose, Chemotherapy, and Hormonal Factors in Breast Cancer Following Hodgkin's Disease

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Authors

FLFlora E. van LeeuwenCardio-Oncology WKWillem J. KlokmanThe Netherlands Cancer Institute MSMarilyn StovallThe University of Texas MD Anderson Cancer Center

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Implication

Nested case-control study reveals breast cancer risk rises with radiation dose but falls with chemotherapy-induced early menopause in Hodgkin disease survivors, indicating hormonal tumor promotion.

Key Points

To evaluate how radiation dose, chemotherapy, and hormonal factors affect secondary breast cancer risk among female Hodgkin's disease survivors.
Conducted a nested case-control study within a Dutch cohort of 770 female patients diagnosed with Hodgkin's disease before age 41.
Evaluated 48 case patients who developed breast cancer 5 or more years post-diagnosis and 175 matched control subjects, estimating localized breast radiation dose and applying conditional logistic regression.
Breast cancer risk increased significantly with radiation dose (P_trend = .01), with doses ≥38.5 Gy yielding an RR of 4.5 (95% CI = 1.3 to 16) compared with <4 Gy, reaching an RR of 12.7 (95% CI = 1.8 to 86) in the radiotherapy-alone group.
Patients treated with both chemotherapy and radiotherapy experienced a significantly lower risk than those treated with radiotherapy alone (RR = 0.45, 95% CI = 0.22 to 0.91).
Early menopause before age 36 markedly reduced breast cancer risk (RR = 0.06, 95% CI = 0.01 to 0.45), occurring in 69% of patients treated with radiotherapy and >6 chemotherapy cycles versus 9% with radiotherapy alone.

Cite This Study

Leeuwen et al. (2003) studied this question.

synapsesocial.com/papers/6a7d096900c5c9efbcaa07bf https://doi.org/10.1093/jnci/95.13.971

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Implication

Nested case-control study reveals breast cancer risk rises with radiation dose but falls with chemotherapy-induced early menopause in Hodgkin disease survivors, indicating hormonal tumor promotion.

Roles of Radiation Dose, Chemotherapy, and Hormonal Factors in Breast Cancer Following Hodgkin's Disease

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Implication

Key Points

Cite This Study

Roles of Radiation Dose, Chemotherapy, and Hormonal Factors in Breast Cancer Following Hodgkin's Disease

Discussion

Member takes

Implication

Key Points

Cite This Study

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